Title: RE: 837 P Test File with corresponding "HCFA 1500" analogue

Henry,

 

Correct me if I am mistaken but I believe what is being described is your translator mapping testing scenarios. The translation process is being tested to ensure that the fields from the 1500 map correctly to the appropriate data elements in an 837. The adjuster is familiar with the data representation on a 1500 and would like to cross-reference what he understands with that mapped data reflected in the 837. This is an appropriate methodology for testing the human function of building translation maps. Under this testing process, the expected result should be known which would be the original claim in the 1500 format. >From a payer perspective the easiest and most logical way of proving correct mapping is to take existing 1500’s in production and have them represented in a compliant 837’s. The 837 would then be sent through the translator and converted back to the original 1500 for adjudication. The analyst now has the original production file (the expected result) to compare to the HIPAA test file (837).

 

The two test files do not have to match in relation to the extraneous data contained in an 837, only in relation to the data elements brought forward for adjudication in proprietary format. Please contact me offline for the data and methodology to accomplish your goals, it is available and not very complicated.

 

Regards,   

 

Mark A Lott

President/CEO

HIPAA Testing, Inc.

www.hipaatesting.com

 

Executive Co-Chair HCCO - Transactions Group

HIPAA Conformance Certification Organization

www.hcco.us

 

Office: 480-946-7200

Cell:   480-239-5112

Fax:  877-272-2841

 

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-----Original Message-----
From: Henry Perretta [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, March 26, 2003 1:23 PM
To: WEDI SNIP Transactions Workgroup List
Subject: 837 P Test File with corresponding "HCFA 1500" analogue

Does anyone happen to know of test data (either for sale or free) where you could have two items:

a) a test 837 Professional claim --- and ---
b) a HCFA 1500 "representation" (and I realize this is a matter of some subjectivity) that corresponds to the test 837 Professional file above?

You're probably asking: why would someone want something like that? --- Here's why: If you have (as a payer) a need for claims adjusters to SEE a metaphor (or analogue) of a HIPAA EDI claim - AS WELL AS - the need to feed appropriately converted data from that HIPAA EDI claim into your claims system - then part of testing involves making sure you "render" that EDI claim appropriately...

Anyway, anyone hear of anybody offering such a "test pair"?

thanks ....

Henry A Perretta
6302 Dunman Way
Alexandria, VA 22315
703-298-4851

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The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time.

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